Pathophysiology: Osteoporosis occurs when the rate of bone production cannot keep up with the rate of bone absorption, causing decreased bone density. Cancer patients receiving chemotherapy have an increased risk of developing osteoporosis. Most chemotherapeutics reduces bonemineral density (BMD) and increases risk for fractures by causing gonadal suppression, which in turn increases bone removal. This rapid rate of bone destruction makes it difficult for the body to keep up with production of new bone to replace it. This condition is manifested by a stooped posture, loss of height, back pain related to fractured or collapsed vertebrae and commonly occurring fractures. Its most commonly diagnosed by a DEXA scan, or dual energy x-ray absorptiometry.
DEXA scan
Increase dietary Calcuim
Nursing Interventions:
Prevention
Adequate intake of Calcium, Vitamin D and weight bearing exercise (as tolerated) can decrease the risk of Osteoporosis - at least 1200mg of Calcium and 800-1,000mg of Vit. D.
Dietary Modifications, consume foods high in Calcium such as dairy products, dark leafy greens, tofu, salmon, and sardines (with bones)
Avoid tobacco smoking and alcohol consumption
Patient Education
Explain all tests and procedures
Teach patient ways to prevent falls and injuries- wear proper fitted shoes, remove clutter, install bars in showers and tubs, avoid walking on icy paths alone
Assessment
Check the patient's skin for areas of warmth and redness, assess for new pain sites
Monitor pain level and response to treatment
Provide emotional support and reassurance
Drug therapy:
Biophosphonates - calcium regulation and bone resorption inhibitor
Alendronate (Fosamax)
Risedronate (Actonel, Atelvia)
Ibandronate (Boniva)
Zoledronic Acid (Reclast, Zometa)
Synthetic Hormones - stimulates new bone formation
Teriperatide (Forteo)
Calcitonin, salmon (Fortical)Estrogen Replacement therapy for Women
Human Monoclonal antibody - inhibits osteoclast activity and production
OSTEOPOROSIS AND BONE HEALTH
Pathophysiology: Osteoporosis occurs when the rate of bone production cannot keep up with the rate of bone absorption, causing decreased bone density. Cancer patients receiving chemotherapy have an increased risk of developing osteoporosis.
Most chemotherapeutics reduces bonemineral density (BMD) and increases risk for fractures by causing gonadal suppression, which in turn increases bone removal. This rapid rate of bone destruction makes it difficult for the body to keep up with production of new bone to replace it. This condition is manifested by a stooped posture, loss of height, back pain related to fractured or collapsed vertebrae and commonly occurring fractures. Its most commonly diagnosed by a DEXA scan, or dual energy x-ray absorptiometry.
Nursing Interventions:
Drug therapy:
References:Mayo Clinic http://www.mayoclinic.com/health/osteoporosis/DS00128U.S. National Library of Medicine http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001400/
MedScape http://www.medscape.com/viewarticle/749909